Individual
KELLI LORAY MCINTOSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDM, CPM
Contact information
Practice address
PO BOX 90309, PORTLAND, OR 97290-0309
(503) 549-4714
(503) 506-0441
Mailing address
15025 NE ROSE PKWY, PORTLAND, OR 97230-4522
(503) 329-4107
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
L11679
OR
176B00000X
Midwife
Primary
DEM-LD-10112926
OR
Other
Enumeration date
02/15/2007
Last updated
02/19/2025
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